Turkish Neurosurgery 2014 , Vol 24 , Num 6
Leptomeningeal Dissemination of Pilocytic Astrocytoma in a 17-Year-Old Boy
Ali BabaeI JANDAGHI1, Elham BIDABADI2, Seyed Mohammad SEYED SAADAT3, Babak ALIJANI4, Saeid DALIRI1, Zoheir REYHANIAN4, Mehryar MASHOUF5
1Guilan University of Medical Sciences, Poursina Hospital, Department of Radiology,Rasht, Iran
2Guilan University of Medical Sciences, Department of Pediatric Neurology, Rasht, Iran
3Guilan University of Medical Sciences, Rasht, Iran
4Guilan University of Medical Sciences, Poursina Hospital, Department of Neurosurgery,Rasht, Iran
5Arya Hospital, Department of Neurosurgery, Rasht, Iran
DOI : 10.5137/1019-5149.JTN.9769-13.1 Pilocytic astrocytoma with leptomeningeal dissemination is a rare phenomenon and can be associated with obstructive hydrocephalus and an unfavorable prognosis. Herein, we report a seventeen-year-old boy with a history of ventriculo-peritoneal shunt insertion due to severe hydrocephalus who presented with progressive headache and vomiting together with ocular and cerebellar signs and symptoms. Neuroimaging confirmed the presence of multiple intracranial masses in the cerebellum and thalamus. Intracranial dissemination of tumor to the the leptomeninges was seen during neuroendoscopy. Simultaneous biopsy and endoscopic third ventriculostomy were performed and the diagnosis of low-grade pilocytic astrocytoma with leptomeningeal dissemination was made by histological examination. The patient underwent chemotherapy in combination with radiotherapy to reduce the risk of reoccurrence of the primary tumor and was followed for one year. Keywords : Pilocytic astrocytoma, Leptomeningeal dissemination, Hydrocephalus, Neuroendoscopy
Corresponding author : Seyed Mohammad Seyed Saadat, arman.saadat@gmail.com